Synergy Dru Yoga Registration Form

Thank you for completing this registration form and health questionnaire. The following information confirms your registration and assists us to help you get the best out of your yoga experience and provide the highest level of safety and care for you.

Your information is considered private and will remain strictly confidential.

CONTACAT DETAILS

SURNAME ...... GIVEN NAMES......

ADDRESS......

TOWN/ SUBURB...... POSTCODE......

DATE OF BIRTH......

TEL ( HOME)...... TEL (WORK)......

(MOBILE)………………………………...... EMAIL ......

OCCUPATION......

REFERRING PERSON ......

How did you find out about the class? …………………………………………………………………………………………………......

FEES

$20/session payable on the day. Pay for the term and receive 2 free classes.

I agree to receiving newsletters and emails from Synergy Manual Therapy and Yoga. I agree to take full responsibility for my own health and wellbeing during the class and when I practise anything taught in the Dru Yoga class in another location. I agree to notifying the teacher if there is any change in my medical condition.

Signed ...... Date ...... /...... /......

Synergy Dru Yoga—Karen Custance Manual Therapist/Physiotherapist, Grad Dip Phys Dru Yoga Teacher, Dip DYT, DPN (Dru Professional Network) YTISA (Yoga Teachers Institute South Australia)

www.synergymanualtherapy.com T: 83652680 E:[email protected]

Synergy Yoga - What is Dru Yoga?

Dru Yoga is a synthesis of ancient yoga methods adapted to the modern day world. Dru Yoga can wash away stress, ease back pain, increase energy levels and relieve the pressures of modern living. It is a flowing style of yoga with an emphasis on soft joints, the breath, visualisation, core strength and spinal mobility to achieve balance in the body and mind. It is gentle and therapeutic so is available to all.

All Dru classes will involve most of these elements.

Activation or warm up Using dynamic flowing movements all the bodily systems are activated, which enhances circulation and in- creases our awareness of the body to prepare for the class.

Energy Block Sequence (EBR) These sequences systematically mobilise the joints and muscles and in particular the spine releasing tension allowing the body to soften and energy to flow. They help us to detox from the inside out, release negative patterns, restore emotional balance and direct us towards achieving our goals.

Asana or Posture Dru Yoga incorporates many traditional yoga postures (positions that you hold the body in) but presents them in stages and with modifications so they are achievable by everyone. Each posture has its own benefits for the body, organs and emotional wellbeing.

Dru Yoga Sequences Sequences of flowing movements in synchrony with the breath and soft joints direct the body's own natural healing and empowering responses to where they are needed.

Pranayama or Breath Control An ancient yogic science, that deals with the control of the life-force or energy within our body. This is achieved by the practice of various breathing exercises.

Relaxation A 4 stage deep relaxation will enable you to deeply relax and heal your body. The benefits of your Dru Yoga session are integrated during a deep relaxation.

Meditation Meditation is a practice of concentrated focus upon a sound, object, visualization, the breath, or movement to reduce stress, promote relaxation, and enhance personal and spiritual growth.

Please visit www.druyoga.com for further information and online studio.

Synergy Dru Yoga Health Questionnaire

The information you provide here enables us to provide the highest level of understanding and safety for your wellbeing during the class. Without information on health conditions, injuries or changes it cannot be guaranteed that you will get the most out of your session.

Please tick the boxes and give brief details.

Anxiety Hernia

Arthritis High Blood Pressure

Back Conditions Insomnia

Cancer Joint Replacement

Chronic pain Low Blood Pressure

Depression Neurological Conditions eg stroke/ms

Diabetes Osteoporosis

Digestive Conditions Pregnant/Post Natal see over eg IBS, Crohns

Dizziness Recent Surgery

Epilepsy Respiratory Conditions eg asthma

Eye Conditions Major Injury/Trauma eg glaucoma/detached retina

Gynaecological Conditions Thyroid Conditions

Headaches Urinary Bladder/Prostate Conditions

Heart Conditions Other Chronic Health Condition

Synergy Yoga Health Questionnaire cont

Are you taking any medication or supplements? Yes/No Please list.

Pregnancy

If you are pregnant, how many weeks?

If you are post natal, how many weeks?

Emotional Wellbeing

How would you rate your stress level currently?

0 No stress, 10 Maximum Stress, please circle 0 1 2 3 4 5 6 7 8 9 10

How would you rate your work life balance?

0 In balance, 10 Out of balance, please circle 0 1 2 3 4 5 6 7 8 9 10

Yoga Experience

Have you ever practiced yoga? Yes/No

Are you currently practicing yoga? Yes/No

How long have you practiced for?

What style of yoga have you practiced?

www.synergymanualtherapy.com T: 83652680 E:[email protected]

Synergy Dru Yoga Information and Courtesies

Classes are run on Wednesdays during term time.

Location: Knightsbridge Guide Hall, corner Glynburn Rd and Rochester St, Leabrook.

Classes start promptly at 9.30am and finish at 11am.

You are welcome to arrive a few minutes earlier to prepare and get settled.

Please bring a mat, cushion, bolster if you have one, blanket and water.

Wear loose comfortable clothing.

Don’t eat a heavy meal before class.

Please switch off your mobile phones.

You must be comfortable and pain free throughout your class. You are responsible for listening to your own body. If you experience pain at any time during the class, please stop and seek advice from your teacher.

Please notify us if you are unable to attend due to sickness or personal reasons.

If you have any other queries please do not hesitate to contact me, I look forward to meeting you.

Namaste Karen